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The phenomenon of social withdrawal, known as the hikikomori-like idiom of distress (HLID), has been reported in many countries. This study aimed to explore profiles of Omanis who have HLID.

A cross-sectional online survey of 673 out of 1,529 Omanis identified with HLID using the Hikikomori Questionnaire (HQ-25) score of 42+.

Two profile groups were determined through cluster analysis according to socio-demographic and HQ-25 outcomes. Subjects in cluster 1 (n = 168, 24.9%) are significantly younger (p < 0.001) and more educated (p = 0.019), spend more time online (p < 0.001) and are living alone (p < 0.001) than subjects in cluster 2 (n = 505, 75.1%). More subjects in cluster 1 had a past mental illness (p = 0.037) but less previous childhood physical/emotional abuse (p = 0.029) than subjects in cluster 2. In contrast, subjects in cluster 2 had a low lack of socialization (p < 0.001), less active isolation (p < 0.001) and total HQ-25 scores (p < 0.001) than cluster 1. Subjects in Cluster 1 have more serious social withdrawal issues than those in Cluster 2, especially on a lack of socialization and isolation.

One limitation that might influence the results of this online study was that information was collected via self-report, and a cross-sectional design limits its results because it cannot assess causal inference. This study has contributed valuably to exploring different profile groups of HDLD, especially in the Arabian Gulf. The authors’ findings facilitate the development by creating innovative interventions strategically tackling different hikikomori groups.

While social withdrawal characterized by HLID has been reported proliferating in different parts of the world, little research has been forthcoming from Arabian Gulf countries. These findings suggest that there are two orthogonal clusters of HLID among Omanis. This study provides a foundation for further research on HLID, which has recently been reported in different parts of the world.

The literature tends to use ‘asylum seeker’ and ‘refugee’ interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique position in British society which differentiates them from people with refugee status and which may have implications for their mental health. For example, ‘asylum seekers’ are supported and accommodated in dispersal areas under the National Asylum Support Service and they are not entitled to work. This mixed‐methods study investigated asylum seekers' symptoms of psychological distress, using mental health screening questionnaires (N = 29) and asylum seekers' subjective experiences of the asylum process, its potential impacts on their mental health, and participants' suggestions for tackling mental health needs, using in‐depth interviews (N = 8). Asylum seekers, refugees and practitioners working with asylum seekers were consulted from the outset regarding the cultural sensitivity of the measures used. Given the potential limitations of using ‘idioms of distress’ across cultures, interview data provided rich descriptive accounts which helped locate the mental health needs that the asylum seekers experienced in the specificities of each participant's social context. Asylum seekers originated from 13 countries. The results revealed that psychological distress is common among asylum seekers (for example anxiety and post‐traumatic stress), but so are post‐migratory living difficulties (for example accommodation, discrimination, worry about family back home, not being allowed to work). They also report mixed experiences of health and social care services. These results suggest that asylum seekers' unique social position may affect their mental health. Implications for practice are presented and potential limitations highlighted.

This paper explores issues surrounding the under‐representation of people from the Gujarati community in mental health statistics and services in the UK and asks why people from the Gujarati communities are less likely to seek assistance for mental health problems. It is well known that members of the African‐Caribbean community are over‐represented in mental health statistics, and this is attributed to factors such as racial discrimination, social adversity and stress of migration. However, members of the Gujarati community have also been exposed to these hardships, but are not similarly represented in the mental health statistics. The paper explores a selection of the key literature. Two questions are considered: first, whether this group genuinely has very good mental health (and if so why); and second, whether there are any factors that hold members of this community back from seeking help.

This paper describes a survey carried out by a South Asian women's voluntary organisation to identify the physical and mental health needs of its users. The results confirm research findings that suggest a high proportion of South Asian women suffer from psychological and somatic symptoms that are commonly associated with anxiety and depression. A considerable number had experienced racial discrimination and several had suffered sexual discrimination. Problems reported by participants included eating disorders, marital difficulties and domestic violence. The majority did not know where to seek help for mental health problems. Respondents wanted confidential talking and complementary therapies to be provided in services run by South Asian staff, and for health education and health promotion to be provided in their own ethnic language. The paper ends with a consideration of the implications of these findings for the delivery of mainstream mental health services, from health promotion through primary care to specialist services.

This paper explores the central role a language interpreter can play in the process of the therapeutic relationship. Although others have described the changes to the therapeutic dyad that the presence of a third party (an interpreter) brings, little attention has been paid to the advantages and additional opportunities of this altered therapeutic situation. This paper details these gains and further argues that clinicians who are willing to gain experience of working with interpreters will find that benefits accrue at the micro and macro levels: at the micro level, through enhancement of their work with individual non English speaking clients, and at the macro level through learning about different cultural perspectives, idioms of distress and the role of language in the therapeutic endeavour. This is in addition to developing skills to fulfil legal and professional requirements relating to equity of service provision. Some ideas are offered to explain the negative slant than runs throughout the literature in this area and tends to colour the overall discussion of therapeutic work with interpreters and, before the final section, makes some specific suggestions which may help maximise the gains possible in such work while reducing difficulties.

The Bhutanese refugee camps of eastern Nepal are home to a mass resettlement operation; over half the population has been relocated within the past five years. While recent research suggests Bhutanese refugees are experiencing degradation of social networks and rising suicide rates, little is known about ethnocultural pathways to coping and resilience in this population.

A common coping measure (Brief COPE) was adapted to the linguistic and cultural context of the refugee camps and administered to a representative sample of 193 Bhutanese refugees as part of a broader ten‐month ethnographic study of resilience.

Active coping, planning, and positive reframing were the most frequently utilized strategies, followed by acceptance, religion, and seeking emotional support. Exploratory factor analysis resulted in five factors: humor, denial, behavioral disengagement; positive reframing, planning, active coping; emotional support, instrumental support; interpersonal (a new sub‐scale), acceptance, self‐blame; and venting, religion.

Data support the relevance of some dimensions of coping while revealing particularities of this population.

Findings can inform future research and intervention efforts aimed at reducing suicide and promoting mental health across the Bhutanese refugee diaspora.

This is the first mixed‐methods study of coping in the Bhutanese refugee camp population since the start of a mass resettlement exercise. Qualitative data and ethnography were used to illuminate measured trends in local coping behavior.

The purpose of this paper is to identify symptoms that constitute a shared cultural model of depression among African Americans and to compare these accounts with criteria for major depressive disorder (MDD) in the 5th edition of the Diagnostic Statistical Manual of mental disorders (DSM-V).

Data were collected in a disproportionately Black urban neighborhood in the USA and analyzed using cultural consensus analysis (CCA). In total, 34 African Americans participated in a free-listing exercise to elicit common indicators of depression in the same community. Another 40 key informants completed a survey to rate how common each indicator was in the same community. Factor analysis was performed, factor loadings were used to weight the responses of each informant in the survey and then aggregated to determine the most significant indicators or components of the shared model depression.

Indicators of depression included classic symptoms in the DSM-V such as sadness and lack of motivation. However, other indicators that are inconsistent with symptoms of MDD in the DSM-V such as paranoia and rage were common and constituted a shared model of depression in the sample.

Some symptoms common among African Americans that are not in the DSM-V or on research instruments developed based on the DSM could be overlooked in epidemiological surveys and in clinical assessments of depression.

The provision of mental health care might benefit from a better understanding of how contextual factors shape expressions of distress among African Americans.

This study identify culturally salient symptoms of depression among African Americans independent of clinically defined criteria.

This paper aims to examine the long‐term mental health consequences of war from the perspectives of urban Mayan women in post‐war Guatemala.

Ethnographic methodologies, namely participant observation and in‐depth qualitative interviews were carried out during 12 months of fieldwork in Guatemala City.

The findings indicate that urban indigenous women confront a range of unresolved war‐related traumas and psychosocial distress that require specific attention by researchers, policy makers and service providers. It is argued that psychosocial interventions aimed at addressing the traumas of war must take into account present day conditions of post‐war violence, poverty, and social inequity that threaten the health and well‐being of indigenous peoples.

Recommendations are provided for promoting the mental health of urban indigenous women affected by war.

Research that has been conducted on the mental health effects of war has tended to focus on rural areas of the country. This article advances the research on post‐war Guatemala through a focus on urban Mayan indigenous women.

While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is to survey UM attending a detention centre in Oporto (Portugal) to estimate the prevalence of mental health disorders in this population.

A retrospective chart review was performed with the relevant sociodemographic and clinical data of all UM in the process of coercive removal from Portuguese territory, observed by Doctors of the World, during three years (2014–2016). The Tenth Version of International Classification of Mental and Behavioural Disorders was used for nosological classification.

In total, 393 detainees were eligible for the study. Most detainees were male (84 per cent) and 76 months was the mean length of stay in Portugal before detention. In total, 29 per cent of detainees were diagnosed with a mental and behavioural disorder. The most prevalent diagnosis was neurotic, stress-related and somatoform disorders (47 per cent). UM with dual diagnosis (28 per cent) led to the articulation with the integrated centres of drug addiction, which provided and monitored opioid substitution therapy. Female UM were more prone to develop any mental and behavioural disorder when compared to men (χ²=7,017; p<0.05).

In total, 9 per cent of the detainees were excluded from this study due to incomplete data on their medical charts. Some detainees presented oppositional behaviour, hostility towards others and refused to be assessed by the medical team. Both situations could have biased the prevalence of mental disorders. Finally, the appropriateness of the western model of mental health disorders (ICD-10) in the study population is controversial, considering the culture-bound phenomenology and syndromes.

This paper identified the most prevalent mental health disorders in UM detained in Portugal. The most prevalent mental health disorders were either stress-related (associated with the detention itself) or related to previous patterns of substance abuse. Given the study outcomes, it is highly recommended to mobilise human and technical resources to provide specialized mental health care to UM at least while detention policies could not be changed.

This paper builds on existing studies by drawing on Conservation of Resources theory to explore the losses, psychological impacts as well as recovery processes of the 2017/18 volcanic disaster on Ambae Island, Vanuatu.

This discussion is based on local perspectives and personal accounts collected through a series of eight semi-structured interviews (five males and three females).

The volcanic activity and subsequent displacement and evacuation led to significant resource loss which had a spiralling nature, causing psychological harm. Locals invested resources to recover and protect against future loss in diverse ways and, as resource gains were secured, experienced emotional relief. Key to recovery and healing included returning “home” after being displaced and reinvigorating cultural practices to re-establish cultural continuity, community and identity. Resource gains spiralled as people reconnected and regained a sense of place, optimism and the motivation to rebuild.

Numerous studies have drawn upon the Conservation of Resources (COR) theory to explore how resource loss can trigger psychological distress during environmental disasters; however, it has not been applied in Vanuatu, the most at-risk nation globally to natural hazards. This paper builds on existing studies by exploring personal accounts of resource loss, distress and recovery, and providing insights into resource spirals, caravans and passageways.